Provider Demographics
NPI:1144347741
Name:KOLHOFF, SHAWN MARIE (MA, LLP)
Entity type:Individual
Prefix:MRS
First Name:SHAWN
Middle Name:MARIE
Last Name:KOLHOFF
Suffix:
Gender:F
Credentials:MA, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2174
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49003-2174
Mailing Address - Country:US
Mailing Address - Phone:269-312-1446
Mailing Address - Fax:
Practice Address - Street 1:1125 E MILHAM AVE STE B
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-3096
Practice Address - Country:US
Practice Address - Phone:269-312-1446
Practice Address - Fax:269-225-6949
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2025-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012543103TC1900X
MI6361001249103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling